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Topic Review
Janus Kinase Inhibitors for Inflammatory Bowel Disease
Janus kinase inhibitors are small-molecule drugs that can be administered orally and are relatively inexpensive, thus offering an additional option for treating Inflammatory bowel disease (IBD). They have been shown to be effective in patients with ulcerative colitis (UC), but they are less effective in those with Crohn’s disease (CD).
  • 311
  • 26 Oct 2021
Topic Review
Herbal and Hepatocellular Cancer
Cirrhosis is the most important risk factor for the development of Hepatocellular cancer (HCC). Thus, it is estimated that one out of three patients with cirrhosis will suffer from HCC during their lifetime. Although chronic viral hepatitis, chronic alcohol intake and metabolic-associated fatty liver disease (MAFLD) are responsible for most cases of cirrhosis, any other cause of cirrhosis (such as herbal causes) might result in hepatocellular carcinoma.
  • 311
  • 24 Nov 2022
Topic Review
Role of Intestinal Microbiota in Pathogenesis of NAFLD
The term “gut microbiota” refers to the microorganism community residing in the intestinal lumen, while the term “gut microbiome” refers to the entire ecological habitat, including the microorganisms as well as their genomes and the surrounding environmental conditions. There has been a growing body of evidence linking the presence of intestinal dysbiosis to the pathogenesis of human liver disease, with a primary focus on metabolic diseases, including non-alcoholic fatty liver disease (NAFLD).
  • 309
  • 08 Aug 2022
Topic Review
Oxidative Stress and Nervous Distress in Gastrointestinal Disorders
Oxidative stress is increasingly recognized as a central player in a range of gastrointestinal (GI) disorders, as well as complications stemming from therapeutic interventions. The dysfunction of the ENS is characteristic of a spectrum of disorders, including neurointestinal diseases and conditions such as inflammatory bowel disease (IBD), diabetic gastroparesis, and chemotherapy-induced GI side effects. Neurons in the Enteric nervous system (ENS), while essential for normal gut function, appear particularly vulnerable to oxidative damage. Mechanistically, oxidative stress in enteric neurons can result from intrinsic nitrosative injury, mitochondrial dysfunction, or inflammation-related pathways. Although antioxidant-based therapies have shown limited efficacy, recognizing the multifaceted role of oxidative stress in GI diseases offers a promising avenue for future interventions.
  • 309
  • 01 Nov 2023
Topic Review
Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome
Metabolic syndrome (MetS) is characterized by an association of cardiovascular and diabetes mellitus type 2 risk factors. Although the definition of MetS slightly differs depending on the society that described it, its central diagnostic criteria include impaired fasting glucose, low HDL-cholesterol, elevated triglycerides levels and high blood pressure. Insulin resistance (IR) is believed to be the main cause of MetS and is connected to the level of visceral or intra-abdominal adipose tissue, which could be assessed either by calculating body mass index or by measuring waist circumference. Studies revealed that IR may also be present in non-obese patients, and considered visceral adiposity to be the main effector of MetS’ pathology. Visceral adiposity is strongly linked with hepatic fatty infiltration also known as non-alcoholic fatty liver disease (NAFLD), therefore, the level of fatty acids in the hepatic parenchyma is indirectly linked with MetS, being both a cause and a consequence of this syndrome.
  • 308
  • 23 Feb 2023
Topic Review
Sleep among Patients with Chronic Liver Disease
Sleep disturbances are commonly encountered among patients with CLDs and are associated with impaired HRQOL. The present study demonstrated that the more severe the liver disease, the poorer that sleep and QOL are. 
  • 307
  • 09 Jan 2022
Topic Review
Management of Radiation-Induced Esophageal Cancer
Radiation-induced esophageal cancer (RIEC) can arise in a previously irradiated field, mostly in patients previously irradiated for thoracic malignancies such as breast cancer, Hodgkin and non-Hodgkin lymphomas, head and neck cancers, lung cancer, or previous esophageal cancer. RIEC is rare and accounts for less than 1% of all carcinomas of the esophagus. RIEC seems to represent a biologically aggressive disease with a poor prognosis. Although it is difficult to perform radical surgery on a previously irradiated field, R0 resection remains the mainstay of treatment. The use of neoadjuvant and adjuvant chemoradiotherapy remains very helpful in RIEC, similarly to conventional esophageal cancer protocols.
  • 307
  • 01 Aug 2022
Topic Review
Artificial Intelligence Application to Pancreas Imaging
Despite the increasing rate of detection of incidental pancreatic cystic lesions (PCLs), current standard-of-care methods for their diagnosis and risk stratification remain inadequate. Intraductal papillary mucinous neoplasms (IPMNs) are the most prevalent PCLs. The existing modalities, including endoscopic ultrasound and cyst fluid analysis, only achieve accuracy rates of 65–75% in identifying carcinoma or high-grade dysplasia in IPMNs. Furthermore, surgical resection of PCLs reveals that up to half exhibit only low-grade dysplastic changes or benign neoplasms. To reduce unnecessary and high-risk pancreatic surgeries, more precise diagnostic techniques are necessary. A promising approach involves integrating existing data, such as clinical features, cyst morphology, and data from cyst fluid analysis, with confocal endomicroscopy and radiomics to enhance the prediction of advanced neoplasms in PCLs. Artificial intelligence and machine learning modalities can play a crucial role in achieving this goal. 
  • 307
  • 30 Oct 2023
Topic Review
Hepatitis B Virus-Associated Hepatocellular Carcinoma
Hepatitis B virus (HBV) affects around 300 million people worldwide and is a significant risk factor for the development of hepatocellular carcinoma (HCC). Nucleos(t)ide analog therapy has aided in decreasing mortality from HBV.
  • 305
  • 21 Feb 2024
Topic Review
Diagnosis of Post- Endoscopic Retrograde Cholangiopancreatography Pancreatitis
Endoscopic retrograde cholangiopancreatography (ERCP) is the primary therapeutic approach for disorders affecting the pancreatobiliary tree. It carries the highest risk of complications and mortality among other endoscopic modalities, with post-ERCP pancreatitis (PEP) being the most frequent complication, even after a seemingly straightforward procedure. Its incidence lies between 2–10%, which could be as high as 30–50% in high-risk cases. PEP is severe in up to 5% of cases, with potential for life-threatening complications, and death in up to 1% of cases. The risk of PEP is potentially predictable and may be modified with pharmacological measures and endoscopic techniques, also patient selection plays an important role.  The therapy for PEP is like that of acute pancreatitis. Analgesia and supportive care with moderate fluid therapy are often sufficient in most patients. In conclusion, PEP is a potentially life-threatening complication of ERCP which can be mitigated through a correct patient selection, combination of pharmacological and intraprocedural measures as well as prompt diagnosis and early management.
  • 304
  • 20 Oct 2022
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